HOW the GOP will win in their War on ACA..

[BadGimp]

This is why the GOP kicks the Democrats ASSES every time.

Link to tweet

?ref_src=twsrc%5Etfw

They know exactly how to engage in and dominate the messaging game. I see this approach as #PUREGENIUS #AGame delivery and a massive #GOPWIN. The Dems have no scalable messaging that can win at this point that I have seen.

Telling the truth is a fast track to #FAIL.

I fear this might be a nail in the coffin for ACA/Obamacare.

Remember friends: Messaging is HOW Trump won over his base, and expanded same.

[guillaumeb]

1. So if one does not have the ability to buy what one needs..........one should be prepared to die.

Thanks, Paul Ryan

[iamateacher]

2. That works until

The person realizes their new health insurance is worse than their old one, with less coverage, more deductibles, etc. It will take a while, but it does sink in...let's hope it sinks in before Nov. 2018...
It took a while for the Iraq War, too.

[JHan]

3. Except he was owned in the tweet replies.

[Ilsa]

4. Insurance is the process of betting that you'll get

Really sick or very hurt, and you're sharing that fonancial risk with otherss who do the same. "Fit your needs" should be broad, not narrow, to support the concept of insurance.

[Yavin4]

10. That's why we collectively pay for a fire and police department

We're sharing the cost burden instead of eating the entire cost when our houses are on fire.

[Ilsa]

17. Exactly. Or hoping the fire at the neighbor's house

doesn't catch yours on fire. We want everyone to have access to county fire abatement/rescue.

[atreides1]

5. I don't believe people are that stupid!

Considering the questions being asked of those who have had town hall meetings, Ryan is just fellating his corporate masters, again!

That message Trump sent out, isn't working!

The message now is that if you lose your access to the ACA, you're going to die!

[gratuitous]

8. Oh they are that stupid

But it's time we pushed back on their bogus use of the word "freedom." Dying in agony from a totally preventable or treatable disease is not what most people would call "freedom," Speaker Ryan.

It shouldn't be all that hard to push back on this nonsense, but we have to do it every time they say or tweet something stupid, instead of just counting on people to remember it's stupid. We're definitely bad at that, because we figure once someone gets it, they'll retain it, so we don't need to go repeating ourselves over and over again. The Republicans have no such qualms about repeatedly telling their base stupid stuff until the base has internalized the stupidity and doesn't even question it anymore.

[Charles Bukowski]

6. Trump won because rural votes count more than city votes.

No other reason.

As for messaging, the ACA is currently more popular than the moron-in-chief and the Republican Congress.

Stay strong. Republicans are masters of wrecking everything in sight. This time around will be no different. When they're done laying waste to this country, THAT'S when we'll have full control of the narrative. Hell, the narrative will write itself.

[Caliman73]

41. Not to mention the cheating.

We cannot forget that Trump won by 80,000 votes across the battleground states and that hundreds of thousands of eligible voters were denied their franchise by Republican Secretaries of State, and legislatures that pushed Crosscheck and other methods of suppressing or denying the vote.

They do not have the numbers, but they were able to tamp ours down sufficient to squeak out an electoral college win.

Remember that our candidate won 3 million more votes than their candidate, and collectively, our congressional candidates won 21 million more votes than theirs.

That is a long way of saying rural votes count more than city votes but we should spell it out.

If it is one thing we can count on it is Republican overreach. We just have to survive long enough to be able to pick up the pieces or as President Obama said repeatedly, to get the keys back and pull the car out of the ditch.

[NightWatcher]

7. "Necessitous men are not free men."- FDR

I'm free to buy a Ferrari, but it doesn't mean that I have the ability.

[louis-t]

9. And yet, the GOP will not provide anything close to what

they claim they are providing. They will call it Freedomcare, take away anything that is meaningful, then pat themselves back and claim victory.

[Freethinker65]

11. But this line of attack is far less effective after people have and have been using "Obamacare"

Once you have insurance from the ACA and have needed to use it, or personally know of others that have it and had to use it, you begin to understand the true value and purpose of insurance.
For those that have never had health insurance, or have been lucky enough not to "need" it, Ryan's hollow soundbite might sound reasonable. Those that have seen their rates go up and/or subsidies go down might also be taken in by Ryan's tweet at first. Those that have been able to access healthcare with Obamacare when they needed it and saw what they pay for their care vs. what the insurance pays for their care are less likely to fall for the GOP's less upfront cost for far less coverage shell game.
The Democrats have their own soundbites- emotional stories from people whose lives and families were saved by Obamacare/the ACA. Those stories are from what the GOP likes to call "real Americans" and it scares the hell out of them. They are running away from town hall meetings to avoid such confrontations.

[alarimer]

12. No, WEALTH is the ability to buy what you want that fits your needs.

The thing about health care is that you never know what you are going to need or when you are going to need.

Paul Ryan is an evil fuck.

[onenote]

13. "Every time" must mean something different where you're from

Unless, of course, you think the Democrats got their asses kicked in the presidential elections in 1992, 1996, 2008 and 2012. And while I'm at it, I'll throw in 2000 (not exactly an ass-kicking, right?) and 2016 (unless you share Trump's view that he won a historically huuuge victory). Looking at House and Senate elections, over the past 25 years (not "every" but a nice sample) there have been years when the Democrats got their asses kicked and years when they did the ass-kicking and years where it was pretty even.

[annabanana]

14. "buy what you want to fit what you need".. HORSESHIT

Buy whatever you can afford and hope it covers what you end up needing..(more like)

[elleng]

15. Right, it's always 'messaging.'

They know exactly how to engage in and dominate the messaging game.

Telling the truth is a fast track to #FAIL.

Does George Lakoff know something conservatives don't? ( a good oldie)

'In his new book, Moral Politics: What Conservatives Know That Liberals Don't, Santa Fe Institute Science Board Member George Lakoff traces the political beliefs of both conservatives and liberals to metaphors for the ideal family. Not surprisingly, conservatives and liberals have different versions of that ideal family. For conservatives, political metaphors evolve from a strict-father family model; for liberals, a nurturant-parent model. Lakoff claims that our common nation-as-family metaphor projects these opposed family models onto politics. Family-based morality, he argues, can explain why liberal and conservative views cluster together: what one's views on gun control have to do with one's views on environmentalism, social programs, taxes, abortion and so on.'>>>

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=104x1308418

[jetcat]

16. "Freedom is the ability to afford the health care that you need. Obamacare is Washington

working for you to meet that need."

And btw Paul, freedom is not the ability to live behind behind gilded gates and give your fellow-citizens the middle finger.

[mwooldri]

18. Freedom is also the ability to work for whoever you like.

Obamacare is Washington's way of helping you work for whoever without having to worry about healthcare.

(Edit to add more: Take away Obamacare, take away my freedom to work for whoever.)

[jetcat]

19. Oddly enough, a decidedly conservative economic argument for single-payer healthcare.

It is an argument that conservatives have now decided to abandon in the name of team-politics, but it had some pretty strong adherents in its day.

[mwooldri]

20. Exactly. I'd argue that Brits are freer under the NHS than Americans.

Employers don't have to worry for health insurance... if they do it's plans like Bupa that offer ability to jump the queue on certain types of care. A lot of "elective" care (e.g. hip replacements) under the NHS is subject to a wait list. If your employer offers Bupa and you pay for Bupa, you might get your hip replacement sooner rather than later.

It may be socialized health care, it may be London telling me what kind of care I can have, what kind of doctors I can see, etc. but in my mind it offers much more freedom than the American system.

The USA does have the best medicine that money can buy. It is also the most expensive. Last year, the budget for Medicare was for $672 billion. (source here) The budget for the National Health Service in England was £107 billion (source here, page 5) - or about $135 billion. Population of England: 53 million. Population of USA: 319 million. Population receiving Medicare: 55.3 million (source here). Granted, Medicare is for helping out the elderly and the disabled, so yes those people have more medical expenses than the average person. But Medicare is 5x more expensive than the entire NHS England budget.

[Trust Buster]

21. A message for the chronically ignorant maybe. Going back to forcing the insured to pay the cost

of millions of uninsured showing up in emergency rooms IS NOT FREEDOM AT ALL !!!!!!

[Bengus81]

22. For the millionth time,you DO NOT have to buy ACA insurance....

No one says you can't just call up Blue Cross/Blue shield and buy a policy on your own. All you have to prove is that you HAVE health insurance.

[Gary S]

23. The Republicans only had to do 1 thing to cripple the ACA, and they did it....

Last edited Fri Feb 24, 2017, 10:37 AM - Edit history (8)

Much is being said about the increasing premiums and the reduction in choices under the Affordable Care Act. By far the greatest cause of these problems was the betrayal of the insurance companies by the U.S. House of Representatives.

Providing health insurance for a large group of individuals without having had prior experience with that group is very risky, especially when preexisting conditions are allowed and lifetime maximums are removed. The Affordable Care Act included a premium stabilization provision ("risk corridors" 1) that was designed to help cap insurance companies' risk in this uncertain environment. If claims paid by an insurer exceed a certain level, the provision would kick in and the insurance company would get help covering its loss. This provision was/is so important that House Speaker Paul Ryan's “A Better Way Healthcare Initiative” replacement plan includes "risk pools" to protect insurers 2, and he's willing to put aside $25 billion over 10 years to fund it 2,3. Secretary of Health and Human Services Tom Price’s plan provides $3 billion for similar risk pools over 3 years.4

So it would seem everyone is in agreement that some type of risk pool or risk cap is necessary to help insurers deal with the unpredictable nature of individual health insurance policies.

What happened? Why did premiums go up? Why did insurers pull out? When insurance companies submitted their bills under the Affordable Care Act’s risk corridor provision, the Republican controlled congress funded only $362 million (or 12.6 percent) of the $2.87 billion requested by insurers in 2014 5. This single act of betrayal by the House (whereby the risk coverage that had been assured when they set their premiums was not paid) made it inevitable that rates would rise and that some insurers would withdraw their plans. Insurers had to increase their rates to cover the risk that the ACA said Congress would cover.

Congressional betrayal continued in 2015 and 2106, such that the limited funds available in 2015 and 2016 were still being used to pay off 2014 obligations, and the U.S. Department of Health and Human Services notified insurers that they should anticipate no payments for the 2015 risk corridors 6.

The U.S. House of Representatives betrayed ALL of us when they knowingly withheld risk corridor payments necessary for the Affordable Care Act to work. They knew that their action would raise premiums, and reduce choice. I write this in the sincere hope that Republicans and Democrats will work together to make our healthcare system work.



SOURCES

1 Public Law 111-148 Patient Protection and Affordable Care Act, Section 1342 [42 U.S.C. 18062]. Establishment of risk corridors for plans in individual and small group markets"

2 www.politico.com Concerns rise in New York over Republican proposal for high-risk pools, Dan Goldberg, 01/18/17 05:28 AM EST, and http://www.forbes.com/sites/realspin/2017/01/28/will-paul-ryans-obamacare-replacement-work-for-people-with-pre-existing-conditions/#7282c650c3a6
3 abetterway.speaker.gov “High Risk Pools”, Page 21

4 www.healthmarkets.com “Tom Price’s Healthcare Proposal: 7 Changes You Need to Know About” Item 2, “Provide Funding for Risk Pools”

5 www.law360.com “ACA Risk Corridor Funding Falls Short, Litigation Ensues”, Law360, New York (June 9, 2016, 10:57 AM EDT)

6 Health and Human Services Memo “Risk Corridor Payments for 2015”, September 9, 2016. https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-Stabilization-Programs/Downloads/Risk-Corridors-for-2015-FINAL.PDF

[crazylikafox]

24. Thank you! Best explanation I've read about how the Repubs sabataged the ACA. Bookmarked.

And welcome to DU!

[rzemanfl]

25. Great first post! Welcome to DU. n/t

[riversedge]

27. Welcome and thanks for this.

[riversedge]

28. Please start a separate thread for this Very Important Information. It will also make it

tweetable.

[Gary S]

36. Sorry, this was my first post. I don't see a main folder for the Affordable Care Act.

Could you either move my post where it should be or give me a hint how/where to report it?

[Brother Buzz]

37. Just wait until you have ten post, then you can make an OP

Posting it right here in General Discussion would be fine and it will certainly reach the most eyes.

Welcome, and if your first post is any indication, you will be a fine asset to DU.

[Rhiannon12866]

40. Excellent first post and explanation, thank you!

And welcome to DU!

As my fellow DUers said, anyone who joins needs to post 10x before they can start an original thread. But you're halfway there and I also agree, this would make an excellent OP. It's important information and would fit in just fine right here in General Discussion, the busiest and most viewed forum on DU.

[Gary S]

38. And I don't have the privileges to start a threat because I am too new. Can you fix that?

[NRaleighLiberal]

39. You have to make ten posts until you can create an original post.

(not just you of course! Any new joiner to DU)

[Maru Kitteh]

44. I hope you will post this as an OP here in General Discussion as soon

as you have the requisite 10 posts.

Very well done. Welcome to DU.

[riversedge]

26. I think the Town Halls are sending a powerful message also. IMHO

[C_U_L8R]

29. Everyone has a plan until they get punched in the face

said Mike Tyson.

Even if Republicans win the bullshit war,
they will be completely fucked when people start
getting sick and dying from their stupid repeal.

[MFM008]

30. I dont agree

Yes, we still need to be cage fighters with repukes but I dont care what they say, the framework for the ACA will remain, just like Bohener said today.

[BeyondGeography]

31. Just wait for those Black Friday chemo specials!

Free at last, free at last, thank God Almighty...

[VOX]

32. These ideologues want (fake) "choice" for everything but women's rights.

The moment a Repub trots out, "It's all about choice," run away. Fast. Because it means they are taking a hacksaw to something positive and of genuine help, and offering the taxpayer nothing. Their motto should read, "Privatize everything, but socialize the debt."

All their talk about shrinking government is utter bullshit, because they have no qualms about getting into women's private lives. Or how we school our kids to know actual history, not about Jesus and his horse Dino.

Christ, we're still fighting the Civil War. Oh, yeah, that's not politically correct for the unreconstructed Southerner, who cries if you don't say, "The War of Northern Aggression."

[Captain Stern]

33. I don't think the GOP really has a war on the ACA.

Their war was against 'Obamacare'. By that, I mean Obama.

When they knew Obama would veto their votes to repeal 'Obamacare', they were safe. They could convince their base that it was the worst thing ever, and that they were trying their best to repeal it. They held vote after vote to repeal it.

Now they control the House and Senate. If they really wanted to repeal the ACA, they could do it tomorrow. But, they won't. Because they know that it's better than what we had, and they know that we know that too.

[Liberal In Texas]

34. And it's a complete lie.

The ACA put minimum coverages, among other things, that the insurance companies had to do, to keep people that thought they were covered from being completely f*cked when they get sick.

[wishstar]

35. No, they're not winning since public knows GOP has no plan to make insurance more affordable

They only way they could 'win' would be if they actually increased subsidies so premiums could go down and if they also expanded Medicaid in all the Repub controlled states so more people could be covered affordably.


"'Telling the truth is a fast track to Fail?" that is the repub game plan as they lie constantly, knowing they can't win if truthful.


If everyone understood "the truth" and not Repub propaganda, Dems would win the arguments every time.

[Gary S]

42. President Trump took another step to cripple the ACA on January 20...

President Trump took another step to cripple the Affordable Care Act on January 20 when he issued an order to halt $5 million in advertising, and outreach activities in the final days of the 2017 enrollment period. 1 The Washington Post reported that staffers at Health and Human Services protested because history had shown the advertising was necessary to prompt younger, healthier people to enroll, with the final deadline traditionally having been the second biggest enrollment day of the cycle. 2 Last year, nearly 700,000 people selected plans a week before the final deadline. 3.

Former HealthCare.gov CEO Kevin Counihan predicted that the move could depress enrollments of the most needed customers by several hundred thousand. "It's counterproductive...To be frank, I think it's fairly transparent...I think the intention is to suppress enrollment...This has a material impact on enrollment." 4

Ben Wakana, a former senior spokesman at HSS, had this to say...“It’s outrageous. It’s irresponsible... They are deliberately undermining open enrollment to try to get a lower enrollment number.” 1

It simply amazes me that our President would take this step to sabotage the American healthcare system. Of course he is entitled to dislike the Affordable Care Act and want to replace it. But to purposely take steps that will reduce enrollment of the youngest, healthiest people that are needed to balance the overall risk pool is shameful. It is inevitable that this single action will help raise premiums in 2018, and help push insurers to withdraw plans in 2018 and beyond.

In fact... Marilyn Tavenner, president of America’s Health Insurance Plans, predicts just that if the Trump administration doesn't provide greater assurances of future subsidies: “I think we would lose more insurance companies...and insurers would hike prices by perhaps 20 percent." 5

Whether they like it or not, the Trump administration and his fellow Republicans now own the responsibility for our healthcare system, and steps that decrease enrollment and cripple the current plans prove they care more about politics than building a viable system of care.


1 https://www.bloomberg.com/news/articles/2017-01-27/trump-administration-pulls-some-obamacare-ads-as-deadline-nears
2 https://www.washingtonpost.com/national/health-science/white-house-stops-ads-outreach-for-last-days-of-aca-enrollment/2017/01/26/a2f92682-e420-11e6-ba11-63c4b4fb5a63_story.html?postshare=2881485490750551&tid=ss_tw-bottom&utm_term=.a7962deeec5d
3 http://money.cnn.com/2017/01/27/news/economy/obamacare-ads-trump/
4 http://www.cnbc.com/2017/01/27/ex-healthcaregov-ceo-trump-killed-obamacare-ads-to-suppress-enrollment.html
5 https://www.washingtonpost.com/national/health-science/health-insurers-warn-of-wider-defections-from-aca-marketplaces-for-2018/2017/02/01/c507ec78-e807-11e6-bf6f-301b6b443624_story.html?utm_term=.1877761feb85

[Gary S]

43. The Affordable Care Act is still at risk if Trump or the House move to stop CSR Payments...

The Affordable Care Act uses "Cost Sharing Reduction" payments to help make certain policies more affordable. A detailed explanation of the payments is here...
http://obamacarefacts.com/insurance-exchange/cost-sharing-reduction-subsidies-csr/

Simply put, Cost Sharing Reduction Subsidies lower the amount people have to pay out-of-pocket for deductibles, coinsurance, and copayments. To benefit, enrollees must participate in a Qualified Health Plan, and have enrolled through the Marketplace. These payments are absolutely essential to help keep the cost of plans down.

About 6 million enrollees (including 28,000 Native Americans) currently benefit from these subsidies. 1

What's the status of CSR payments? In November 2014, House Republicans filed suit to block CSR payments. A ruling was made against the payments, but the judge allowed the payments to continue pending appeal. In November, 2016, the House Republicans filed a motion to delay their own lawsuit while they try to figure out their alternative healthcare plan. 2

If the Trump administration and the House Republicans decide to pursue this lawsuit and stop CSR payments, the impact on the Affordable Care Act (and its enrollees) would be devastating. Under the Affordable Care Act, insurers would have to continue to provide the subsidies, and if not reimbursed would result in additional costs to them of about $7 billion this year and $130 billion over the next ten years. 2

Marilyn Tavenner, president of America’s Health Insurance Plans, predicts just that if the Trump administration doesn't provide greater assurances of future subsidies: “I think we would lose more insurance companies...and insurers would hike prices by perhaps 20 percent."3

So there we have it... the next way that our President and the Republicans can cripple our health care system.


1 http://www.tribalselfgov.org/wp-content/uploads/2017/01/TSGAC-Status-of-CSR-Payments-2017-1-6a.pdf
2 http://healthaffairs.org/blog/2016/05/12/judge-blocks-reimbursement-of-insurers-for-aca-cost-sharing-reduction-payments
3 5 https://www.washingtonpost.com/national/health-science/health-insurers-warn-of-wider-defections-from-aca-marketplaces-for-2018/2017/02/01/c507ec78-e807-11e6-bf6f-301b6b443624_story.html?utm_term=.1877761feb85